Stories of Hell and Healing: Internet Users’ Construction of Benzodiazepine Distress and Withdrawal

Abstract Benzodiazepines are a group of drugs used mainly as sedatives, hypnotics, antiepileptics, and muscle relaxants. Consumption is recommended for 2 to 4 weeks only, due to fast onset of dependency and potentially distressing withdrawal symptoms. Few peer-review studies have drawn on the user experiences and language to appreciate firsthand experiences of benzodiazepine withdrawal or discontinuation syndrome. We looked extensively at patient stories of benzodiazepine withdrawal and recovery on Internet support sites and YouTube. Our analysis indicated that users employ rich metaphors to portray the psychologically disturbing and protracted nature of their suffering. We identified seven major themes: hell and isolation, anxiety and depression, alienation, physical distress, anger and remorse, waves and windows, and healing and renewal. By posting success stories, ex-users make known that “healing” can be a long, unpredictable process, but distress does lessen, and recovery can happen

Transfer fiyatlandırmasına ilişkin vergi mevzuatında yer alan yöntemlerin stratejik olarak kullanımı

ÖZETUZUN, Samet. Transfer Fiyatlandırmasına İlişkin Vergi Mevzuatında Yer Alan Yöntemlerin Stratejik Olarak KullanımıTransfer fiyatlandırması, globalleşme olgusuyla beraber sürekli olarak artan ve ülkeler arasındaki ticaret miktarının artması neticesinde, uluslararası vergi literatürünün en önemli tartışma konularından biri olmuştur. Türk vergi mevzuatına 5520 Sayılı Kurumlar Vergisi Kanunu ile "Transfer Fiyatlandırması Yoluyla Örtülü Kazanç Dağıtımı” başlığı çerçevesinde, transfer fiyatlandırması manipülasyonlarını önleme maksadını taşıyan bir vergi güvenlik müessesesi olarak devreye girmiştir.Bu çalışmada, 5520 Sayılı Kurumlar Vergisi Kanunu ve OECD normları kapsamında transfer fiyatlandırması yöntemlerinin tercihi konusu incelenecektir. Bu araştırma dört bölümden oluşmaktadır. Birinci bölümde transfer fiyatlandırması ile ilgili kavramlar, kullanımın sebebi ve önemi, OECD ve diğer ülkelerde transfer fiyatlandırmasın düzenlemeleri, ikinci bölümde, Türk Vergi mevzuatında transfer fiyatlandırması ile ilgili son düzenlemeler, üçüncü bölümde transfer fiyatlandırması yöntemlerinin seçimi ve kullanımı hakkında özellikli durumlar ve dikkate alınacak konular, yöntem seçiminde ortaya çıkabilecek sorunlar, emsal bedel seçiminde karşılaştırabilir fiyat bulma sorunu, hangi sektörde hangi yöntemin kullanılacağı konuları ele alınmıştır. Dördüncü bölümde transfer fiyatlandırması tespitinde vergi denetiminin altyapı oluşturması ele alınmıştır. Araştırma sonucunda mevcut olan transfer fiyatlandırması düzenlemeleriyle beraber Türk Vergi sisteminin uluslararası düzenlemeler kapsamında çağdaş bir yapıya yaklaştığı Transfer fiyatlandırmasının teorik temellerine dayanan transfer fiyatlandırması yöntemleri ile emsal bedel tespit yöntemlerinin birinden bağımsız olmadığı neticesine ulaşılmıştırABSTRACTUZUN, Samet. Strategic Use of Methods That Take Part in Tax Legislation Concerning Transfer Pricing, Master’s Thesis, İstanbul, 2017Due to the concept of globalization and increasing volume of trade between countries, transfer pricing has become one of the most significant debate in international tax literature. Specific transfer pricing rules are enacted in Turkish tax legislation under the Corporate Income Tax Law No. 5520 with the title ‘Disguised Profit Distribution through Transfer Pricing’ as tax security tool that aims at preventing transfer pricing manipulation. In this study, the preference of transfer pricing methods is analyzed within the context of the Corporate Income Tax Law No. 5520 and OECD Guidelines. This study is composed of four chapters. In the first chapter basic transfer pricing terminology is defined, an outline of the purpose and the importance of transfer pricing and transfer pricing regulations in the OECD countries and other countries are provided. In the second chapter, the latest regulations relevant to transfer pricing in Turkish tax legislation are examined. Chapter three concentrates on specific cases concerning the choice and use of transfer pricing methods and the considerations that should be taken into account, the problems resulting from method preference, the problem of finding comparable price in the choice of value of equal and which method will be used in which sector issues. In chapter four, tax auditing working papers samples in determination of transfer pricing are examined. In the conclusion of this study, It is revealed that within the context of international arrangements Turkish tax system approaches to a modern structure in company with present transfer pricing arrangements; transfer pricing methods and determination methods of value of equal that are based upon theoretical base of transfer pricing are not independent each other

Transfer fiyatlandırmasına ilişkin vergi mevzuatında yer alan yöntemlerin stratejik olarak kullanımı

UZUN, Samet. Transfer Fiyatlandırmasına İlişkin Vergi Mevzuatında Yer Alan Yöntemlerin Stratejik Olarak Kullanımı Transfer fiyatlandırması, globalleşme olgusuyla beraber sürekli olarak artan ve ülkeler arasındaki ticaret miktarının artması neticesinde, uluslararası vergi literatürünün en önemli tartışma konularından biri olmuştur. Türk vergi mevzuatına 5520 Sayılı Kurumlar Vergisi Kanunu ile "Transfer Fiyatlandırması Yoluyla Örtülü Kazanç Dağıtımı” başlığı çerçevesinde, transfer fiyatlandırması manipülasyonlarını önleme maksadını taşıyan bir vergi güvenlik müessesesi olarak devreye girmiştir. Bu çalışmada, 5520 Sayılı Kurumlar Vergisi Kanunu ve OECD normları kapsamında transfer fiyatlandırması yöntemlerinin tercihi konusu incelenecektir. Bu araştırma dört bölümden oluşmaktadır. Birinci bölümde transfer fiyatlandırması ile ilgili kavramlar, kullanımın sebebi ve önemi, OECD ve diğer ülkelerde transfer fiyatlandırmasın düzenlemeleri, ikinci bölümde, Türk Vergi mevzuatında transfer fiyatlandırması ile ilgili son düzenlemeler, üçüncü bölümde transfer fiyatlandırması yöntemlerinin seçimi ve kullanımı hakkında özellikli durumlar ve dikkate alınacak konular, yöntem seçiminde ortaya çıkabilecek sorunlar, emsal bedel seçiminde karşılaştırabilir fiyat bulma sorunu, hangi sektörde hangi yöntemin kullanılacağı konuları ele alınmıştır. Dördüncü bölümde transfer fiyatlandırması tespitinde vergi denetiminin altyapı oluşturması ele alınmıştır. Araştırma sonucunda mevcut olan transfer fiyatlandırması düzenlemeleriyle beraber Türk Vergi sisteminin uluslararası düzenlemeler kapsamında çağdaş bir yapıya yaklaştığı Transfer fiyatlandırmasının teorik temellerine dayanan transfer fiyatlandırması yöntemleri ile emsal bedel tespit yöntemlerinin birinden bağımsız olmadığı neticesine ulaşılmıştır ABSTRACT UZUN, Samet. Strategic Use of Methods That Take Part in Tax Legislation Concerning Transfer Pricing, Master’s Thesis, İstanbul, 2017 Due to the concept of globalization and increasing volume of trade between countries, transfer pricing has become one of the most significant debate in international tax literature. Specific transfer pricing rules are enacted in Turkish tax legislation under the Corporate Income Tax Law No. 5520 with the title ‘Disguised Profit Distribution through Transfer Pricing’ as tax security tool that aims at preventing transfer pricing manipulation. In this study, the preference of transfer pricing methods is analyzed within the context of the Corporate Income Tax Law No. 5520 and OECD Guidelines. This study is composed of four chapters. In the first chapter basic transfer pricing terminology is defined, an outline of the purpose and the importance of transfer pricing and transfer pricing regulations in the OECD countries and other countries are provided. In the second chapter, the latest regulations relevant to transfer pricing in Turkish tax legislation are examined. Chapter three concentrates on specific cases concerning the choice and use of transfer pricing methods and the considerations that should be taken into account, the problems resulting from method preference, the problem of finding comparable price in the choice of value of equal and which method will be used in which sector issues. In chapter four, tax auditing working papers samples in determination of transfer pricing are examined. In the conclusion of this study, It is revealed that within the context of international arrangements Turkish tax system approaches to a modern structure in company with present transfer pricing arrangements; transfer pricing methods and determination methods of value of equal that are based upon theoretical base of transfer pricing are not independent each other

Recurrence of Granulosa Tumor of The Ovary in a Bartholin Gland

Objective: Granulosa type of sex-cord stromal tumor of the ovary is rare. They tend to recur late mostly in the pelvis, but intraabdominal and hepatic metastases are also seen. We would like to present a case, operated for granulosa tumor 10 years ago, who had a recurrence in bartholin gland along with intraabdominal metastases. As far as we know, this is the first case in literature of a granulosa tumor recurring in a bartholin gland. Results: Having optimally operated for a stage I granulosa tumor (macrofollicular and diffuse types - grade 2 differentiation) 10 years ago, the 54 year-old-patient with complaints of abdominal distention and presence of a palpable mass in vulva was diagnosed to have widespread relapse. She had mild complaints for almost a year but she did not seek medical advice. The main necrotic mass was around 25 cm and she had two other omental metastasis of around 7 cm, all optimally removed by surgery. The other mass of 5x2.5 cm located in the bartholin gland was also excised. All lesions were reported to be recurrence of the granulosa cell tumor. The patient had adjuvant chemotherapy and was well at her 6th month of postoperative follow-up. Conclusions: Although mostly recurring in pelvis and abdomen, we document a case of recurrent granulosa cell tumor of the ovary in vulvar bartholin gland. Since granulosa tumor recurrences are thought to arise from occult disease, it may be speculated that this recurrence was spread from the intra-abdominal metastasis hematogenously

Microarray detection of human papilloma virus genotypes among Turkish women with abnormal cytology at a colposcopy unit Bir kolposkopi merkezine başvuran anormal sitolojili Türk kadınlarındaki human papilloma virus tiplerinin mikroarray analizi

OBJECTIVE: There is a well-known association between human papilloma virus (HPV) and cervical neoplasia. The aim of this study was to investigate the types of HPV DNA and to compare the results with colposcopic findings among women with abnormal cytology. MATERIAL AND METHODS: A series of 76 consecutive women attending the clinic with the usual referral indications (ASC-US or higher in Pap) were examined by the conventional diagnostic tools (PAP smear, colposcopy,punch biopsy) and subjected to HPV testing. For HPV genotyping, we used a commercially avaliable HPV DNA chip (Genomica-CLART) which is a PCR based microarray system.The HPV test detected 35types of HPV (HPV-6/-11/-16/-18/-26/-31/-33/-35/-39/-40/-42/-43/-44/-45/-51/-52/-53/-54/-56/-58/-59/-61/-62/-66/-70/-71/-72/-73/-81/-83/84/-85/-89). RESULTS: Overall, 44.7% of all patients were HPV positive. HPV was positive in 35%, 51.9%, 77.7% of the ASCUS, LSIL and HSIL groups respectively and HPV 16 was the most prevalent type in all groups. 6 %of patients had mutiple infections. 57.8% of biopsy proven SIL’s were HPV positive. The most prevalent HPV type was HPV 16 (54.5%).Colposcopic assessment revealed pathologic findings in 94.7% of biopsy proven SIL cases. CONCLUSION: Although it has been reported that the prevalence of HPV in the general population is lower than Western countries, and the prevalence and distribution of genotypes are smilar in patients with abnormal cytology. Further population based studies are needed to determine the prevalance and type distribution of HPV with normal and abnormal cytology in Turkish women. Despite the new technological progress in HPV virion, colposcopy is still very important diagnostic tool in the management of abnormal smears

Microarray detection of human papilloma virus genotypes among Turkish women with abnormal cytology at a colposcopy unit

OBJECTIVE: There is a well-known association between human papilloma virus (HPV) and cervical neoplasia. The aim of this study was to investigate the types of HPV DNA and to compare the results with colposcopic findings among women with abnormal cytology. MATERIAL AND METHODS: A series of 76 consecutive women attending the clinic with the usual referral indications (ASC-US or higher in Pap) were examined by the conventional diagnostic tools (PAP smear, colposcopy,punch biopsy) and subjected to HPV testing. For HPV genotyping, we used a commercially avaliable HPV DNA chip (Genomica-CLART) which is a PCR based microarray system.The HPV test detected 35types of HPV (HPV-6/-11/-16/-18/-26/-31/-33/-35/-39/-40/-42/-43/-44/-45/-51/-52/-53/-54/-56/-58/-59/-61/-62/-66/-70/-71/-72/-73/-81/-83/84/-85/-89). RESULTS: Overall, 44.7% of all patients were HPV positive. HPV was positive in 35%, 51.9%, 77.7% of the ASCUS, LSIL and HSIL groups respectively and HPV 16 was the most prevalent type in all groups. 6 %of patients had mutiple infections. 57.8% of biopsy proven SIL’s were HPV positive. The most prevalent HPV type was HPV 16 (54.5%).Colposcopic assessment revealed pathologic findings in 94.7% of biopsy proven SIL cases. CONCLUSION: Although it has been reported that the prevalence of HPV in the general population is lower than Western countries, and the prevalence and distribution of genotypes are smilar in patients with abnormal cytology. Further population based studies are needed to determine the prevalance and type distribution of HPV with normal and abnormal cytology in Turkish women. Despite the new technological progress in HPV virion, colposcopy is still very important diagnostic tool in the management of abnormal smears

Clinical predictors and significance of adherent periadrenal fat in laparoscopic adrenalectomy

Abstract Background Adrenalectomy requires the anatomic preparation of the adrenal gland in the fat-rich retroperitoneal space. In the literature, it was shown that the retroperitoneal fat area affects surgical outcomes in laparoscopic adrenalectomy (LA). Besides the quantity of retroperitoneal fat, its qualitative properties play hypothetically a significant role in the safety profile and perioperative parameters of LA. In this study, we aimed to evaluate the factors associated with adherent periadrenal fat. Methods The prospectively obtained demographic, preoperative, intraoperative, and postoperative data of 44 patients who underwent laparoscopic adrenalectomy in our clinic were analyzed retrospectively. The patients were divided into two groups as adherent periadrenal fat (APAF) and non-APAF group. Periadrenal fat tissue was defined as adherent or non-adherent by the attending surgeon according to the difficulty in dissection of the adrenal gland from the surrounding fat tissue during the operation. Results The rate of female gender and presence of diabetes mellitus (DM) was higher in the APAF group (respectively, p = 0.038 and p = 0.001). A ROC curve analysis showed that the cut-off point was − 97 HU for APAF. On multivariable analysis using a stepwise regression model, we identified the presence of DM (OR = 5.073; 95% Cl = 2.192–12.387; p = 0.006) and ARFD > -97 HU (OR = 3.727; 95% Cl = 1.898–11.454; p = 0.008) as an independent predictor of APAF. Conclusion APAF seems to affect the perioperative outcomes of LA in terms of operation duration but not perioperative complications